I'm working in the lab of a large hospital while waiting to start the nursing program at my local community college this fall.
I was on phlebotomy tonight and before one of my draws the patient's RN pulled me aside outside the room (in the hall) and told me to "be careful because she's HIV positive." Another phlebotomist related that the RN had also advised him of the patient's HIV status before he drew the patient earlier in the evening.
As a phlebotomist, you'd have to be point-blank stupid not to approach every draw as if the patient had a blood-borne pathogen. That's why we have things called personal protective equipment and universal precautions. A patient's HIV status is and should be irrelevant when it comes to drawing blood since you should be taking the same degree of precaution with every draw that you do.
I believe that the RN needlessly compromised the patient's right to confidentiality, especially with such a highly confidential diagnosis. In addition to what seems to be to be a serious breach of ethics on the part of the RN, it also sounds like a big, glaring HIPPA violation.
I'm not even in RN school yet and it's setting off alarms with me. Am I off base in my assessment of the situation? I'm seriously considering reporting it to our compliance officer, my motivation not being to "nail" the RN, but rather to take advantage of the situation as a teaching opportunity for the RN, and also advocate for the patient who probably has no idea that her confidentiality was breached.
Any thoughts from you seasoned professionals would be most appreciated!
I agree. It is not only ethically inappropriate, it is also without scientific basis.
"Ethically inappropriate" in your opinion and while I would probably love to have you as my nurse since this part of our lively discussion involves opinions we will have to agree to disagree this time.
Well of course. We're all stating our opinions here. Just as long as folks realize they may be violating the patient's right to confidentiality, and thus violating the law, which can result in consequences to the individual engaging in this practice. Just as one should realize when they fail to use standard precautions that they may be putting their own health at risk, they should realize when they fail to maintain confidentiality of a patient's HIV status, they may be putting their job or their license at risk.
This has been an interesting debate. But I have a pinning ceremony to attend now! I'll check in later.
The "me too" BTW referred to thinking you did the right thing - everyone's posting faster than me!
And Nancy, sorry to you, too - I knew you knew and posted that to reinforce that reporting it doesn't mean nurses being hauled out of bed in the middle of the night by a combination of the nurses' board, the police and HIPAA legislators.
Wow! This thread really makes me question if I really want to finish completing my degree, only to have to work among backstabbing tattle-tales! Geez! What a cut-throat profession this is! When I worked in surgery for five years, we all discretely gave each other heads-ups on if a patient was positive. The surgeons, techs, clinicians... everyone appreciated to know. It was discrete. Much worse laws are violated everyday folks. There are too many nitpicky people on here IMO. If it was a big ole bad violation, then the OP should of just took the nurse aside in a diplomatic way if it was really bothering him that much. But you nurses that just love to play Johnny Law on here are ridiculous. Believe me, I know from experience that the clerical staff can and do look up that info and are in the "the know". Yes, yes, yes.... we all know its "the law". But look at the big picture here people. I am sure that nurse would never have tried to alert the OP if she had known it was going to be such a big deal to him. Now if you had heard her gossiping with other staff about the patient... that is a whole different story. It is a gray area.. Not black and white. Sorry.
Wow! This thread really makes me question if I really want to finish completing my degree, only to have to work among backstabbing tattle-tales! Geez! What a cut-throat profession this is! When I worked in surgery for five years, we all discretely gave each other heads-ups on if a patient was positive. The surgeons, techs, clinicians... everyone appreciated to know. It was discrete. Much worse laws are violated everyday folks. There are too many nitpicky people on here IMO. If it was a big ole bad violation, then the OP should of just took the nurse aside in a diplomatic way if it was really bothering him that much. But you nurses that just love to play Johnny Law on here are ridiculous. Believe me, I know from experience that the clerical staff can and do look up that info and are in the "the know". Yes, yes, yes.... we all know its "the law". But look at the big picture here people. I am sure that nurse would never have tried to alert the OP if she had known it was going to be such a big deal to him. Now if you had heard her gossiping with other staff about the patient... that is a whole different story. It is a gray area.. Not black and white. Sorry.
Good, now we can all be drug dealers with no worry about people 'tattle taling.' Noi one makes junkies use. So since it's not a big bad ole violation it's ok. Speedong is ok too, even if a few people die every year. It's no big deal. A crime is a crime.
It's right or it's not. It's black or it's white. Your sense of morality notwithstanding no one is playing Johnny Law. If you are not prepared to be a patient advocate why become a nurse? Sorry.
Cannot give you credit on that analogy Stanley. It doesn't even make sense. Comparing nurses to drug dealers? I think you just like to argue for the sake of arguing.
I still stand firm, even though it technically may not be legal, that anyone taking care of patients where there is a risk of exposure should be privy to that information. Nurses are supposed to be considered professionals, right? Physicians are entitled to that info when examining a patient correct? Why are nurses or any staff providing direct patient care not given the same professional respect?
Specializes in Community Health, Med-Surg, Home Health.
Wow! This thread really makes me question if I really want to finish completing my degree, only to have to work among backstabbing tattle-tales! Geez! What a cut-throat profession this is! When I worked in surgery for five years, we all discretely gave each other heads-ups on if a patient was positive. The surgeons, techs, clinicians... everyone appreciated to know. It was discrete. Much worse laws are violated everyday folks. There are too many nitpicky people on here IMO. If it was a big ole bad violation, then the OP should of just took the nurse aside in a diplomatic way if it was really bothering him that much. But you nurses that just love to play Johnny Law on here are ridiculous. Believe me, I know from experience that the clerical staff can and do look up that info and are in the "the know". Yes, yes, yes.... we all know its "the law". But look at the big picture here people. I am sure that nurse would never have tried to alert the OP if she had known it was going to be such a big deal to him. Now if you had heard her gossiping with other staff about the patient... that is a whole different story. It is a gray area.. Not black and white. Sorry.
I see this as a gray area with a black and white law. Maybe what needs to be reviewed is what is the criteria of who 'needs to know' (which, I think that the phlebotomist is definitely one that does).
Again, I don't think that in any way, the patient should receive less than respectful, quality care at all. I can see, though, how a nurse would consider a phlebotomist a team member that deserves the same consideration. I just spoke about this to a nurse a few minutes ago, and she told me that her floor has what they call 'green' (how this connects, I'll never know). Their Patient Care Associates are the blood drawers for their floor. They don't have chart access, but this is their way of telling, but not telling to be aware.
I wouldn't let this along deter you from being a nurse. One of the things about ethics is that no two people will agree, and this is why they have an ethics committee (not to say that I have agreed with their solutions either). Another good reason for forums like this (at least for me), is reading about situations such as these and seeing that people will not ever agree. I see most people expressing their stand on this articulately and effectively. Doesn't mean that we will all agree.
Specializes in Community Health, Med-Surg, Home Health.
Cannot give you credit on that analogy Stanley. It doesn't even make sense. Comparing nurses to drug dealers? I think you just like to argue for the sake of arguing.
I still stand firm, even though it technically may not be legal, that anyone taking care of patients where there is a risk of exposure should be privy to that information. Nurses are supposed to be considered professionals, right? Physicians are entitled to that info when examining a patient correct? Why are nurses or any staff providing direct patient care not given the same professional respect?
:yeah:In addition to what you just stated, I believe that ancillary staff that may also gain exposure to the same issues (such as the phlebotomists) should also be privy to this information.
Cannot give you credit on that analogy Stanley. It doesn't even make sense. Comparing nurses to drug dealers? I think you just like to argue for the sake of arguing.
I still stand firm, even though it technically may not be legal, that anyone taking care of patients where there is a risk of exposure should be privy to that information. Nurses are supposed to be considered professionals, right? Physicians are entitled to that info when examining a patient correct? Why are nurses or any staff providing direct patient care not given the same professional respect?
No, no, no. I compared criminals to criminals. Don't blur the issue or try to make it personal. A physician is privy because HIV status may affect what treatments/medicines/etc. the patient receives. It's about the patient. Not the physician. Only if knowing will benefit the patient should the direct care staff be told. It's not about professional respect it's about professionals behaving that way and obeying the law...
It is illegal. Not technically illegal. If you break that law you are a criminal. A drug dealer is a criminal too. Criminals are criminals... You get the point.
If you were about to draw blood on a patient who had let's say... CJD, which is always fatal and turns your brain to mush, would you want to be aware of this dx? There seems to be debate on whether the prions are transmitted through blood products and the CDC says the risk is probably low for this.. But would you still want to know or would you not care? Just curious.
Specializes in Community Health, Med-Surg, Home Health.
Stanley,
If you were about to draw blood on a patient who had let's say... CJD, which is always fatal and turns your brain to mush, would you want to be aware of this dx? There seems to be debate on whether the prions are transmitted through blood products and the CDC says the risk is probably low for this.. But would you still want to know or would you not care? Just curious.
I'd sure wish to know about CJD! Even moreso than the rest...
Pagandeva. I totally agree with you. And this is the point I am making. How come something like CJD which is much more fatal, devastating, and I would think because of that would carry the same kind of stigma as HIV if not worse... how come something like CJD could be disclosed to healthcare workers but not HIV?
Jules A, MSN
8,864 Posts
"Ethically inappropriate" in your opinion and while I would probably love to have you as my nurse since this part of our lively discussion involves opinions we will have to agree to disagree this time.